Value  of  Social  Service  as  an  Agency  in 
the  Prevention  of  Nervous  and 
Mental  Disorders. 

!y  Its  Importance  as  a  Part  of  the  Work  of  Hospitals  for  the 
Insane  and  of  a  State  Society  for  Mental  Hygiene, 

By  CLIFFORD  W.  BEERS 

Executive  Secretary  of  The  Connecticut  Society  for  Mental  Hygiene. 


Read  at  the  37th  National  Conference  of  Charities  and  Corrections, 
St.  Louis,  Missouri,  May  19-26,  1910 


Had  it  been  possible  for  Dr.  Henry  S.  Noble,  Chairman  of 
the  Executive  Committee  of  The  Connecticut  Society  for  Mental 
Hygiene,  to  be  present  at  this  Conference,  you  would  now  be 
listening  to  an  address  by  a  Superintendent  of  a  State  Hospital 
for  the  Insane  on  the  subject  of  Social  Service  in  connection  with 
such  institutions.  As  it  is,  however,  the  duty,  and  the  privilege, 
of  presenting  a  paper  on  this  important  topic' Tills  to  my  lot  as 
the  Executive  Secretary  of  the  only  State  Society  for  Mental 
Hygiene  as  yet  organized.* 

In  discussing  Social  Service  from  the  view-point  of  the  lay¬ 
man  and,  I  may  add,  from  the  vantage-point  of  the  ex-patient, 
I  shall  hope  so  to  present  the  subject  as  to  emphasize  certain 
aspects  of  the  problem  which  might  fail  of  their  proper  emphasis 
if  discussed  from  a  single  point  of  view.  r 

I  find  myself  today  in  an  embarrassing  position.  I  have  come 
here  to  tell  you  about  the  work  of  the  Connecticut  Society  for 

♦During  the  past  year  a  Society  for  Mental  Hygiene  has  been  founded  in  Illinois.  It 
has  been  organized  in  the  form  of  a  Committee,  of  which  Miss  Julia  C.  Dathrop  of  Hult 
House,  Chicago,  is  Chairman.  It  is  planned  that  this  Committee  shall,  as  occasion  may 
demand,  grow  into  a  fully  organized  State  Society  for  Mental  Hygiene. 


2 

cT' 


-The 

if? 


I 


Mental  Hygiene,  and  I  cannot  very  well  do  so  without  making 
frequent  and  intimate  references  to  myself.  The  Society  which 
I  represent  is  so  much  a  part  of  my  work,  and  my  work  is  so 
much  a  part  of  myself  and  of  my  past  experiences,  that  I  must 
ask  the  privilege  of  taking  you  into  my  confidence  at  once,  as 
friends  of  long  standing,  if  I  am  to  present  my  subject  intelli¬ 
gently  within  the  limited  amount  of  time  allotted  to  me.  Only 
by  granting  my  request  can  I  be  made  to  feel  at  ease  in  disregard¬ 
ing  that  humane  convention  of  society  which  decrees  that  one 
speaking  in  public  shall  not  speak  overmuch  of  himself. 

Believing,  as  I  do,  that,  had  such  work  as  The  Connecticut 
Society  has  undertaken  been  inaugurated  a  generation  earlier, 
I  should  have  escaped  the  ordeal  of  mental  collapse  and  commit¬ 
ment  to  hospitals  for  the  insane,  I  naturally  have  a  deep  and 
abiding  interest  in  that  phase  of  the  mental  hygiene  work  which 
relates  to  prevention.  Had  I,  for  instance,  at  the  age  of  eighteen, 
when  I  began  to  worry  myself  into  a  state  of  depression,  had 
access  to  advice  and  information  which  our  Society  ha^  begun 
to  offer,  and  had  I,  as  a  result  of  an  established  and  widespread 
interest  in  mental  hygiene,  sought  such  advice  as  a  matter  of 
course,  as  persons  threatened  with  tuberculosis  now  seek  the 
help  and  advice  they  need,  I  am  confident  that  I  should  not  have 
suffered  the  affliction  of  mental  disorder.  Though  I  sought  med¬ 
ical  advice  and  took  medicine  for  “nerves,”  I  did  not  find  the 
remedy  I  needed,  which  was  a  verbal  corrective  for  thoughts  and 
fears  which  were  to  prove  my  temporary  undoing.  As  related 
in  detail  in  my  book,  I  became  nervous  and  depressed  because 
of  my  fear  that  I  should  develop  epilepsy  as  an  older  brother, 
who  has  since  died,  had  done,  and  this  secret  fear,  which  I  failed 
to  recognize  as  of  sufficient  importance  to  discuss  with  the  gen¬ 
eral  practitioners  consulted,  and  which  they  failed  to  uncover, 
continued  insidiously  to  sap  my  strength  of  mind  until  what  was, 
in  fad,  an  unfounded  and  combatable  fear  became  an  obsession, — 
and  I  became  insane.  At  this  point,  I  feel  it  my  duty  to  state, 
as  I  can  on  the  authority  of  eminent  physicians  who  recognize 
.and  frankly  admit  the  limitations  of  their  profession,  that  thous¬ 
ands  of  cases  of  insanity,  as  preventable  as  my  own  case  orig¬ 
inally  was,  will  continue  to  develop  until  the  public  demands  that 


2 


general  practitioners  shall  cease  to  regard  the  subject  of  mental 
disorders  as  one  requiring  no  especial  study.  (The  exerting  of  an 
educative  pressure  by  the.  public,  such  a  pressure,  for  instance, 
as  is  exerted  with  reference  to  the  prompt  diagnosis  and  treat¬ 
ment  of  tuberculosis,  would  make  it  necessary  even  for  prac¬ 
ticing  physicians  to  study  psychiatry,/ and  would  hasten  the  day 
when  adequate  courses  in  this  important  subject  will  be  included 
as  a  vital  part  of  the  curriculum  of  all  medical  schools.  In  this 
respect,  our  country  is  far  behind  the  countries  of  continental 
Europe  where  no  physician  can  secure  his  diploma  until  he  has 
passed  an  exacting  examination  in  psychiatry.  A  thorough 
knowledge  of  nervous  and  mental  disorders,  however,  even  on 
the  part  of  all  physicians,  will  not  of  itself  be  sufficient.  All 
people  must  be  taught  to  seek  intelligent  advice  promptly,  and 
this  they  will  not  do  until  the  whole  public,  for  generations  per¬ 
haps,  has  enjoyed  the  benefits  of  education  in  mental  hygiene. 
Furthermore,  institutions  wherein  the  numerous  “border-line” 
cases  can  be  treated,  cases  which  are  not  admitted  to  sanitaria 
for  nervous  people  and  which  should  not  be  committed  to  hos¬ 
pitals  for  the  insane,  must  be  established  either  by  the  State  or 
by  philanthropists. 

I  firmly  believe  that  any  well-organized  system  of  Social 
Service,  having  for  its  chief  object  the  prevention  of  nervous 
and  mental  disorders  in  the  community,  cannot  fail  in  time  to 
prevent  the  occurrence  of  a  majority  of  the  preventable  cases 
which  develop  each  year,  but  which,  today,  through  ignorance  or 
neglect,  are  permitted  to  reach  a  stage  where  commitment  is 
necessary  and  cure  so  difficult  or  impossible. 

What  will  such  a  campaign  of  education  mean  to  the  public? 
Eventually  it  will  mean  that  families  in  which  cases  of  nervous 
or  mental  disorder  have  developed,  or  seem  likely  to  develop, 
will,  as  a  matter  of  course,  take  an  inventory  of  their  stock  of 
mental  health,  or  permit  a  physician  or  trained  social  worker 
to  do  so  for  them.  In  this  way  the  weaker  as  well  as  the  more 
sensitive  members  of  a  family  will  be  taught,  or,  if  necessary, 
perhaps  (forced  to  live  within  the  limit  of  their  resistance  to 
these  disorders,  a  limit  which  can  oftentimes  be  determined  by 
a  skilled  observer.  As  we  all  know,  families  in  which  tubercu- 


3 


losis  has  developed,  if  they  are  intelligent,  observe  the  compara¬ 
tively  simple  rules  of  right  living  with  which  they  have  been 
made  conversant  by  the  tuberculosis  propaganda.  Though  the 
correction  and  control  of  faulty  mental  habits  and  endangering 
modes  of  living,  as  related  to  mental  disorders,  is  admittedly 
difficult  of  attainment,  because  the  points  for  attack  are  so  in¬ 
tangible,  a  campaign  of  education  should  at  least  bring  threatened 
cases  of  mental  disorder  under  treatment  promptly  and  make 
their  cure  possible  in  a  majority  of  instances.  \Even  today,  25% 
of  those  who  are  committed  to  hospitals  for  tile  insane  recover 
their  previous  health  and  capacity  for  self-support,  and  an  added 
20 %,  discharged  as  “improved,”  are  also  able  to  return  to  their 
homes.  If  these  encouraging  percentages  of  recovery  can  be 
j  secured  when  comparatively  little  work  in  prevention  is  being 
done,  they  can  certainly  be  raised  through  concerted  and  intelli¬ 
gent  effort,  and  the  more  surely  because  at  least  40%  of  all  cases 
of  mental  disorder  are  due  to  specific  and  avoidable  causes. 

The  phase  of  Social  Service  which  relates  more  directly  to 
the  improvement  of  conditions  among  patients  in  hospitals  for 
the  insane  is,  of  necessity,  a  hospital  problem.  The  physicians 
themselves  are  the  ones  to  decide  what  form  the  social  service 
shall  take  within  the  hospital  walls  and  in  what  way  the  assist¬ 
ance  of  lay  workers  will  be  acceptable.  I  know  of  a  hospital 
where  interested  lay  workers  arrange  for  folk  dances  in  which 
the  patients  take  part,  where  classes  in  calisthenics  are  formed  and 
instruction  in  handicraft  (basketry,  hammered  brass  work,  etc.) 
is  given.  These  stimulating  activities  which  exert  a  remedial 
and  re-educative  effect  upon  the  patients,  inaugurated  in  this 
instance  by  lay  workers  in  collaboration  with  the  medical  staff 
of  the  hospital,  have  since,  in  part  at  least,  been  taken  over  under 
the  direction  o,f  employees  as  a  permanent  feature  of  the  insti¬ 
tution’s  work.  ,  I,  who  have  experienced  the  deadening  monotony 
of  institutional  life,  and  who  have  seen  scores  of  patients  sit 
listlessly  in  the  wards  day  after  day,  can  testify  how  welcome 
^  would  be  the  benefits  of  this  intra-mural  phase  of  social  service. 
Not  only  would  such  friendly  assistance  to  the  patients  make 
them  happier  but  frequent  contact  with  helpful  lay  workers 
would  in  turn  stimulate  nurses  and  attendants,  And,  best  of  all. 


4 


those  nurses  and  attendants  who  could  not  measure  up  to  the 
higher  standard  of  treatment  required  would,  perforce,  be  elim¬ 
inated.  Thus  social  service  would  indirectly  serve  as  a  partial 
remedy  for  the  physical  abuse  of  patients  which  occurs  on  occa¬ 
sion,  as  we  all  know,  in  a  majority  of  hospitals  for  the  insane.* 

It  may  not  be  amiss  for  me  at  this  point  to  refer  briefly  to 
that  phase  of  my  experiences  which  might  be  termed  the  reforma¬ 
tory  period.  I  had  originally  intended  that  my  book  should 
serve  as  a  sort  of  battle  axe  in  a  campaign  of  investigation  and 
reform  to  improve  conditions  among  the  patients.  Continued 
study  of  the  problem,  however,  under  the  guidance  of  hospital 
physicians  and  interested  lay  workers  of  wide  experience,  has 
caused  me  to  abandon  the  rftle  of  militant  reformer  and  to  adopt 
the  more  effective  and  helpful  one  which  I  am  now  privileged  to 
play  as  the  Executive  Secretary  of  a  State  Society  for  Mental 
Hygiene.  Even  though  I  must  eat  my  own  words — whole  para¬ 
graphs,  in  fact,  of  my  book^I  take  occasion  to  assert  that  he  is 
in  error,  be  he  physician  or  layman,  who  believes  that  drastic 
legislative  investigation  is  the  most  effective  measure  at  hand 
for  use  in  permanently  correcting  such  evils  and  deficiencies  in 
treatment  as  may  exist  in  our  hospitals  for  the*  insane.  Legisla¬ 
tive  investigations  are  at  best  mere  makeshifts.)  The  good  that 
they  may  do  is  usually  offset  by  the  harm  they  must  do,  because 
the  disturbing  publicity  incident  to  such  investigations  under¬ 
mines  confidence  in  our  hospitals  and  seriously  hampers  their 
work.  Inasmuch  as  the  desired  and  more  permanent  results  can 
be  obtained  in  another  way,  I  now  unhesitatingly  condemn  legis¬ 
lative  investigations,  except  perhaps  in  a  few  States  where  this 
heroic  remedy  must  be  resorted  to.  before  the  gentler  method  of 
^cooperative  betterment  can  be  undertaken. 

Having  discussed  those  phases  of  social  service  which  relate 
to  prevention  and  work  among  the  patients  in  hospitals,  I  should 


♦The  Chicago  School  of  Civics  and  Philanthropy,  offers  an  "Occupation  Course  for 
attendants  for  the  Insane,”  Several  of  the  more  progressive  hospital  superintendents 
have  already  sent  nurses  and  attendants  to  Chicago  to  take  this  course,  at  the  expense  of 
the  hospitals  to  which  they  return  in  the  capacity  of  instructors  in  handicraft,  etc.  The 
1910  session  of  the  class  will  be  held  from  June  21st  to  J[uly  29th.  Full  information  may  be 
secured  by  writing  to  the  Secretary  of  the  School  of  Civics  and  Philanthropy.  35  Dearborn 
St.,  Chicago,  Illinois. 

The  New  York  School  of  Philanthropy,  105  East  22nd  St.,  New  York  City,  also  offers 
a  Course  for  Attendants,  "designed  to  discuss  the  importance  of  handicraft,  games  and 
educational  play-activities  in  the  discipline  and  improvement  of  inmates  of  institutions.  " 


5 


like  to  speak  of  that  phase  which  is  commonly  referred  to  under 
the  restricting  name  of  “After-Care.”  As  the  preceding  discus¬ 
sion  proves, /After-Care  is  a  relatively  small  part  of  a  compre¬ 
hensive  plan Sor  Social  Service.^)  Today,  what  is  generally  under¬ 
stood  by  After-Care  consists  simply  in  providing  for  the  material- 
needs  of  the  discharged  patient,  who,  unfortunately,  is  not  usually 
brought  into  contact  with  an  After-Care  Committee  until  he  is 
_  about  to  leave  the  hospital.  In  the  ideal  plan  of  Social  Service 
the  social  worker  becomes  acquainted  with  the  patient,  and  his 
family,  at  the  time  of  commitment.  Whether  the  social  worker 
follows  the  patient  through  his  hospital  experience  is  a  matter 
for  the  hospital  physicians  to  decide;  but,  during  that  period, 
there  are  always  the  relatives  to  advise  and  encourage,  and  when 
the  patient  recovers  he  returns  to  a  place  in  the  family  which 
in  some  degree  has  been  kept  open  for  him,  and  to  relatives 
who,  having  at  least  a  comprehension  of  the  situation,  are  able 
to  realize  their  obligation  toward  him.  This  social  service  after¬ 
care  is  a  combination  of  all  phases  of  Social-  Service.  I,  there¬ 
fore,  feel  justified  in  urging  that  existing  After JCare  Committees 
shall  change  their  titles,  as,  I  am  informed,  the  State  Charities 
Aid  Association  of  New  York  plans  to  do  with  reference  to  its 
several  After-Care  Committees.  Why  may  not  such  Committees 
be  known  as  Committees  for  Social  Service  or  for  Mental  Hy¬ 
giene — preferably  the  latter — so  that  they  can  grow,  as  occasion 
may  demand,  into  a  fully  orgaxiized  State  Society  for  Mental 
Hygiene  such  as  we  have  in  Connecticut? 

If  I  have  abandoned  the  role  of  militant  reformer,  and  I  have 
so  far  as  legislative  investigations  are  concerned,  it  is  because  I 
am  convinced  that  the  solution  of  the  more  important  phases  of 
the  problem  discussed  lies  within  the  limits  of  the  Scope  of  the 
Work  which  the  Connecticut  Society  has  recently  adopted.  Be¬ 
fore  discussing  this  plan  for  work,  however,  I  desire  briefly  to 
outline  the  history  of  the  pioneer  State  Society  and  of  the  parent 
organization,  the  National  Committee  for  Mental  Hygiene,  the 
list  of  objects  and  personnel  of  which  is  appended. 

In  “A  Mind  That  Found  Itself,”  which  was  published  in 
March,  1908,  *  it  was  recommended  that  a  permanent  agency  for 

*I,ongmans,  Green  &  Co.,  Publishers,  443  Fourth  Avenue,  New  York  City. 


6 


education  and  betterment  in  the  hitherto  neglected  field  of  nerv¬ 
ous  and  mental  disorders  should  be  brought  into  existence  in  the 
form  of  a  National  Committee,  and  that  this  agency  should  under¬ 
take  a  work  akin  to  that  which  had  already  been  undertaken 
so  successfully  with  regard  to  tuberculosis.  It  had  been  my  orig¬ 
inal  purpose  to  include  in  this  recommendation  the  statement 
that  the  projected  National  Committee  had,  even  prior  to  the  pub¬ 
lication  of  my  book,  been  partially  organized,  at  least  to  the  ex¬ 
tent  of  my  having  secured  acceptances  of  membership  from  more 
than  twenty  persons  of  national  reputation  whose  interest  in  the 
work  had  been  enlisted  during  the  preceding  year.  This  announce¬ 
ment,  however,  regarding  the  National  Committee,  was  not  made 
at  that  time  as  it  was  deemed  advisable  to  work  out  the  problem 
in  one  State  before  attempting  to  inaugurate  an  active  national 
movement.  Therefore,  I  concentrated  my  efforts  on  the  work 
in  my  native  State,  and  the  Connecticut  Society  for  Mental  Hy¬ 
giene,  which  was  formally  founded  on  May  6,  1908,  was  soon 
completely  organized  and  actively  engaged  in  work. 

During  the  first  year  and  a  half,  we,  that  is,  members  of  the 
State  and  National  organizations,  studied  those  aspects  of  the 
problem  directly  related  to  the  work  of  a  State  Society.  As  a 
result  of  this  study,  a  model  and  effective  plan  has  not  only  been 
evolved  but  actually  put  into  operation  in  Connecticut.  With 
slight  changes,  to  meet  varying  conditions  in  given  States,  this 
Scope  of  the  Work,  the  gist  of  which  I  shall  now  present,  can, 
it  is  believed,  be  adopted  by  any  State  Society  that  may  be 
founded. 

The  chief  objects  of  The  Connecticut  Society  for  Mental  Hy¬ 
giene  are:  (a)  to  work  for  the  protection  of  the  mental  health 
of  the  public;  (b)  to  help  raise  the  standards  of  care  for  those 
threatened  with  nervous  or  mental  disorder  or  actually  ill;  (c) 
to  become  a  permanent  agency  for  education  and  betterment  in 
this  hitherto  neglected  field. 

These  objects  the  Society  aims  to  accomplish  in  the  follow¬ 
ing  manner : 

(T)  By  publishing  and  distributing  information  which  will 
help  overcome  the  prevailing  ignorance  regarding  conditions  and 
modes  of  living  which  tend  to  produce  nervous  and  mental  dis¬ 
orders. 


7 


(2)  By  maintaining  an  office  in  at  least  one  of  the  larger 
cities  where  persons  in  need  of  assistance  or  advice  regarding  the 
perplexing  questions  relating  to  nervous  or  mental  disorders 
may,  for  the  asking,  be  brought  into  contact  with  those  physicians 
or  laymen  best  qualified  to  give  the  information  they  desire. 

(3)  By  co-operating  with  institutions,  societies,  State  and 
local  Boards  and  individuals,  engaged  in  the  work  of  protecting 
and  improving  the  health  of  the  public. 

(4)  By  instituting  and  carrying  on  Social  Service  work  under 
the  guidance  of  physicians  in  charge  of  the  hospitals  which  co¬ 
operate  with  the  Society. 

In  a  word,  the  Society  restricts  its  work  to  Social  Service 
and  education,  a  plan  which  all  interested  workers,  even  opposing 
factions  in  any  State,  can  accept.  A  unique  feature  of  the  Con¬ 
necticut  plan  is  that  Social  Service  is  being  carried  on  as  a  part 
of  the  work  of  Hospitals  for  the  Insane  and  of  a  Society  for 
Mental  Hygiene,  under  the  guidance  of  those  superintendents 
who  serve  as  members  of  its  Executive  Committee.  Such  a  plan 
enables  the  superintendents  of  State  and  private  institutions  to 
take  their  logical  and  commanding  part  in  the  *mental  hygiene 
work.  In  Connecticut  these  officials  are  charged  with  responsibil¬ 
ity  for  the  work  and,  in  a  measure,  with  its  success.  As  can 
be  readily  seen,  results  will  be  more  far-reaching  when  the  bur¬ 
den  of  success  rests  upon  the  hospital  officials  than  when  they  are 
simply  called  upon  to  co-operate  with  the  Society  in  an  unofficial 
way. 

Though  the  Connecticut  Society  is  still  in  the  formative  stage 
of  development,  a  sufficient  amount  of  work  has  been  done  to 
prove  that  it  will  enjoy  a  successful  and  continued  existence. 
When  its  organization  was  completed  on  June  30,  1908,  its  mem¬ 
bership  numbered  112.  Early  in  the  following  year  the  member¬ 
ship  was  increased  to  550  by  means  of  a  general  appeal  to  the 
public  in  the  form  of  circular  letters  and  copies  of  the  Prospectus. 
As  an  indication  of  a  healthy  interest  in  mental  hygiene,  it  should 
be  noted  that  the  percentage  of  enrollments  in  New  Haven, 
where  the  work  had  been  made  familiar  to  the  public,  was  higher 
than  is  usually  secured  by  means  of  circularizing,  and  95%  of 
the  original  550  members  paid  their  Annua]  Dues  of  two  dollars. 


8 


During  the  past  few  months  desultory  circularizing  has  been  car¬ 
ried  on,  with  the  result  that  not  only  has  the  membership  been 
increased  to  650  but  the  existence  of  the  Society  has  been  made 
known  to  many  people  who  have  already  sought  its  advice  and 
assistance.  Had  the  organization  possessed  adequate  capital  for 
the  development  of  its  work,  it  would  without  doubt  today  have 
a  membership  of  at  least  1500,  which  would  make  the  Society 
self-supporting.  That  even  a  larger  membership  than  this  can 
eventually  be  secured  seems  certain,  for  we  have  not  yet  availed 
ourselves  of  the  surer  method  of  personal  appeals  which  can  be 
made  by  interested  workers  before  secular  and  church  clubs  and 
other  audiences.  Then,  too,  few  relatives  and  friends  of  the  4,000 
patients  in  Hospitals  for  the  Insane  in  Connecticut  have  as  yet 
taken  an  active  part  in  the  work  of  securing  members,  as  many 
surely  will  when  they  become  familiar  with  the  purposes  of  the 
organization. 

What  the  relatives  of  the  patients  may  do  to  help  the  Society 
has  been  made  plain.  What  the  Society  can  do  for  the  relatives 
may  best  be  emphasized  by  quoting,  with  the  writer’s  permission, 
part  of  a  letter  sent  to  me  last  autumn  by  a  woman  who  had  ap¬ 
plied  for  advice  several  months  earlier,  when  the  question  of 
committing  her  husband  to  a  hospital  was  being  considered. 

“I  want  to  thank  you  again  for  setting  me  right  in  regard  to 
my  husband’s  position  at  the  hospital.  Since  my  interview  with 
you  I  have  experienced  the  only  peace  of  mind  I  have  known 
in  months.  Your  explanations  relieved  my  anxieties  and  dis¬ 
pelled  my  prejudices  to  such  an  extent  that  a  great  burden  has 
been  lifted  from  me.  If  only  I  had  consulted  you  long  ago  I 
should  have  avoided  the  many  mistakes  I  have  made  and  been 
spared  much  unhappiness.” 

In  a  later  interview  this  woman  remarked :  “I  believe  I 
should  have  suffered  a  nervous  or  mental  collapse  had  not  my 
mind  been  relieved  from  worry  when  it  was.  I  am  now  able  to 
secure  restful  sleep,  something  I  hadn’t  enjoyed  for  weeks  prior 
t(j  my  first  interview.” 

This  case  is  especially  interesting  in  that  it  demonstrates  the 
value  of  assistance  which  may  be  given  to  thousands  of  people 
in  this  country  whose  relatives  are  classed  among  the  incurable 

9 


A 


insane.  The  burden  of  worry  which  this  woman  was  carrying 
before  her  unfounded  fears  were  dispelled,  was  one  which  thous¬ 
ands  similarly  situated  must  continue  to  bear  until  a  way  has 
been  found  to  place  before  them  the  comparatively  simple  in¬ 
structions  and  advice  they  so  greatly  need.  Such  a  way  has  been 
found  in  Connecticut.  The  Society  and  the  hospitals  are  to  serve 
as  agencies  of  enlightenment. 

Many  people  have  asked  for  information  regarding  the  cost 
of  maintaining  a  State  Society  for  Mental  Hygiene.  Experience 
gained  in  ’Connecticut  shows  that  an  organization  of  this  kind 
can  maintain  an  office  and  employ  a  stenographer,  and  a  social 
worker,  who,  in  turn,  may  serve  as  assistant  or  active  Secretary, 
at  a  cost  not  to  exceed  $3,000  a  year.  And  this  amount  of  money 
can,  it  would  seem,  be  secured  in  any  State  in  the  form  of  con¬ 
tributions  and  dues.  Though  it  would  cost  more  than  $3,000  a 
year  to  maintain  a  completely  organized  system  of  Social  Service, 
the  expenses  of  a  State  Society  should,  relatively  at  least,  de¬ 
crease  with  the  development  of  its  work.  Many  burdens  which 
a  Society  must  at  first  assume  independently  will  eventually  be 
shared  by  the  State,  either  through  its  hospitals  or  by  means  of 
a  direct  appropriation  to  the  Society  for  its  work  in  prevention, 
which,  after  all,  is  a  State  and  economic  problem.  The  State 
of  New  York,  within  the  past  ten  years,  has  expended  more  than 
$50,000,000  in  caring  for  developed  cases  of  insanity.  It  is  in¬ 
conceivable  that  this  State  and  many  others  will  not  soon  adopt 
the  wiser  policy  of  expending  part  of  their  appropriations  for  the 
prevention  of  mental  disorders. 

What  policy  a  Society  for  Mental  Hygiene  should  adopt  is 
a  question  which  the  interested  workers  in  a  given  State  will  of 
necessity  have  to  decide  for  themselves.  If,  however,  those  who 
help  to  found  a  Society  are  willing  to  limit  the  scope  of  its  work 
to  Social  Service  and  education  as,  I  believe,  should  always  be 
done  at  first,  then  there  need  be  no  great  difficulty  in  bringing  an 
organization  into  existence  and  placing  its  work  on  a  practical 
basis.  Social  Service  and  the  education  of  the  public  are  activities 
which  hospital  officials  can  heartily  support,  but,  which,  owing 
to  the  burden  of  their  fixed  duties,  they  can  not  very  well  initiate 
and  carry  on  without  lay  assistance. 


10 


As  the  Mental  Hygiene  movement  mugc  and  should  spread 
slowly,  so  that  such  State  Societies  as  may  be  founded  shall  enjoy 
a  continuous  and  effective  existence,  it  will  probably  be  a  long 
time  before  this  newer  form  of  organization  has  been  brought 
into  existence  in  a  majority  of  our  States.  In  consequence,  in¬ 
terested  individuals  in  some  parts  of  the  country  will  not  for 
many  years  to  come  enjoy  the  privilege  of  working  for  the  cause 
through  the  agency  of  a  State  Society.  Anybody,  however,  even 
today,  may  take  upon  himself  a  share  of  the  work  which  a  State 
Society  for  Mental  Hygiene  should  strive  to  accomplish.  He 
can,  if  he  will,  serve  as  a  center  of  enlightenment  regarding  the 
principles  of  mental  hygiene  and  their  practical  application;  and 
he  can  constitute  himself  a  missionary  in  this  cause  by  simply 
combating  the  unfounded  and  unfortunately  widespread  prejudice 
which  exists  regarding  the  insane  and  the  institutions  provided 
for  their  treatment.  It  may  be  said  that  the  combating  of  these 
groundless  fears  and  prejudices  is  the  first  logical  point  for  at¬ 
tack  in  the  impending  campaign  of  education. 

Having  discussed  my  own  experiences  so  frankly  today,  I  am 
sure  no  one  will  suspect  me  of  the  ulterior  motive  of  trying  to 
combat  the  prejudice  and  stigma  associated  with  insanity  so  that 
I  myself  may  feel  more  at  ease  in  the  community.  The  fact  that 
I  was  once  a  patient  in  hospitals  for  the  insane  is  to  me  as  a 
thing  apart.  I  can  and  do  view  my  past  experiences  as  com¬ 
placently  as  though  I  had  suffered  a  commonplace  physical  dis¬ 
order  and  been  treated  in  general  hospitals.  If  anyone  considers 
my  point  of  view  unusual,  let  him  remember  that  it  is  not  my 
point  of  view  which  is  unique,  or  strange,  or  surprising,  but  that 
it  is  his  own  point  of  view  which  is  not  only  strange  but,  as  will 
be  discovered  upon  fair  analysis,  absurd  and  untenable.  My 
attitude  is  no  doubt  the  logical  result  of  an  irresistible  desire  to 
accomplish  a  work  which,  of  necessity,  must  be  based  on  my 
experiences  while  insane.  What,  you  may  well  ask,  will  serve  to 
make  all  ex-patients  unconscious  of  the  imagined  stigma  of  in¬ 
sanity?  I  doubt  if  the  insanities  during  the  present  generation 
will  come  to  be  regarded  as  are  the  so-called  physical  disorders. 
Patients,  today,  carry  with  them  into  the  hospitals  the  idea  of 
stigma  and  disgrace  which  most  people  hold,  and  they  inevitably 


ii 


7 


return  to  the  world  with  the  idea  more  deeply  implanted.  But  the 
public  can  at  least  begin  to  endow  posterity  with  immunity  to 
the  imagined  stigma.  ■'  When  everybody  learns  to  regard  mental 
disorders  with  equam’mity,  patients  who  suffer  mental  affliction 
will  perforce  cease  to  feel  stigmatized  by  what  today  is  an  un¬ 
fair  and  unjustifiable  classification  of  diseases. 

My  concluding  message  is  that  each  one  shall  constitute  him¬ 
self  a  center  of  enlightenment  regarding  the  nature  of  mental 
disorders,  their  prevention  and  cure.  As  missionaries  in  the 
cause  it  will  then  become  possible  for  everyone  to  help  those 
afflicted  thousands  who,  unlike  myself,  may  not  be  fortunate 
enough  to  recover  their  mental  health  and  liberty. 


12 


APPENDIX  I 


The  members  of  the  National  Committee  for  Mental  Hygiene, 
as  of  the  date  May  1 ,  1910,  are : 

Mrs.  Milo  M.  Acker,  Hornell,  N.  Y.,  Trustee  of  the  Willard 
State  Hospital;  Miss  Jane  Addams,  Hull  House,  Chicago;  Presi¬ 
dent  Edwin  A.  Alderman,  University  of  Virginia,  Charlottesville, 
Va. ;  ex-President  James  B.  Angell,  University  of  Michigan, 
Ann  Arbor;  Professor  J.  Mark  Baldwin,  Johns  Hopkins  Uni¬ 
versity;  Dr.  Charles  P.  Bancroft,  Superintendent,  New  Hamp¬ 
shire  State  Hospital,  Concord,  N.  H. ;  Mr.  Otto  T.  Bannard,  New 
York  City;  Dr.  Lewellys  F.  Barker,  Johns  Hopkins  University; 
Dr.  Frank  Billings,  Chicago;  Dr.  G.  Alder  Blumer,  Superintendent, 
Butler  Hospital,  Providence,  R.  I. ;  Dr.  George  Blumer,  Yale 
Medical  School,  New  Haven;  Professor  Russell  H.  Chittenden, 
Director,  Sheffield  Scientific  School;  Dr.  William  B.  Coley,  New 
York  City;  Dr.  Owen  Copp,  Executive  Officer,  Massachusetts 
State  Board  of  Insanity,  Boston ;  Dr.  Charles  P.  Emerson,  Super¬ 
intendent,  Clifton  Springs  Sanitarium ;  President  W.  H.  P. 
Faunce,  Brown  University ;  Dr.  Henry  B.  Favill,  Chicago ;  Miss 
Katherine  S.  Felton,  San  Francisco;  Professor  Irving  Fisher, 
Yale  University;  Mr.  Matthew  C.  Fleming,  New  York  City;  Mr. 
Horace  Fletcher,  New  York  City;  Mr.  Homer  Folks,  New  York 
City;  James,  Cardinal  Gibbons,  Baltimore;  President  Arthur  T. 
Hadley,  Yale  University;  Major  Henry  L.  Higginson,  Boston; 
Dr.  August  Hoch,  Director,  Psychiatric  Institute,  Ward’s  Island, 
New  York  City;  Professor  William  James,  Cambridge,  Massa¬ 
chusetts;  President  David  Starr  Jordan,  Leland  Stanford,  Jr., 
University,  Palo  Alto,  California;  President  Harry  Pratt  Judson, 
University  of  Chicago :  Miss  Julia  C.  Lathrop,  Hull  House,  Chi¬ 
cago ;  Professor  Morris  Loch,  New  York  University;  Mr.  Marcus 
M.  Marks,  New  York  City;  Mr.  Lee  Meriwether,  St.  Louis;  Dr. 
Adolf  Meyer,  Director,  Phipps  Psychiatric  Clinic,  Johns  Hop¬ 
kins  University ;  Mrs.  Philip  N.  Moore,  St.  Louis ;  Dr.  J.  Mont¬ 
gomery  Mosher,  Albany,  N.  Y. ;  ex-President  Cyrus  Northrop, 


13 


University  of  Minnesota;  Dr.  Stewart  Paton,  Princeton,  N.  J.; 
Professor  Francis  G.  Peabody,  Harvard  University;  Mr.  George 
Wharton  Pepper,  Philadelphia ;  Dr.  Frederick  Peterson,  Columbia 
University;  Mr.  Henry  Phipps,  New  York  City;  President  Jacob 
Gould  Schurman,  Cornell  University ;  Dr.  M.  Allen  Starr,  Co¬ 
lumbia  University;  Rev.  Anson  Phelps  Stokes,  Jr.,  Secretary, 
Yale  University;  Mr.  Melville  E.  Stone,  New  York  City;  Judge 
Robert  W.  Tayler,  United  States  District  Court,  Cleveland,  Ohio; 
Mr.  Sherman  D.  Thacher,  Nordhoff,  California;  Rev.  Henry 
van  Dyke,  D.D.,  Princeton  University;  Dr.  Henry  P.  Walcott, 
Cambridge,  Massachusetts ;  Dr.  William  H.  Welch,  Johns  Hop¬ 
kins  University;  Surgeon-general  Walter  Wyman,  Public  Health 
and  Marine  Hospital  Service,  Washington,  D.  C. ;  President  Ben¬ 
jamin  Ide  WTheeler,  University  of  California,  Berkeley,  Cali¬ 
fornia;  Mr.  Robert  A.  Woods,  South  End  House,  Boston,  Massa¬ 
chusetts. 

Secretary,  Pro.  Tern.,  Clifford  W.  Beers,  39  Church  St.,  New 
Haven,  Connecticut. 

The  chief  objects  of  the  National  Committee  are:  To  work 
for  the  protection  of  the  mental  health  of  the  public;  to  help 
raise  the  standards  of  care  for  those  threatened  with  mental  dis¬ 
order  or  actually  ill;  to  promote  the  study  of  mental  disorders 
in  all  their  forms  and  relations  and  to  disseminate  knowledge 
concerning  their  causes,  treatment  and  prevention ;  to  obtain  from 
every  source  reliable  data  regarding  conditions  and  methods  of 
dealing  with  mental  disorders ;  to  enlist  the  aid  of  the  Federal 
Government  so  far  as  may  seem  desirable ;  to  co-ordinate  exist¬ 
ing  agencies  and  help  organize  in  each  State  in  the  Union  an 
allied,  but  independent  Society  for  Mental  Hygiene,  similar  to 
the  existing  Connecticut  Society  for  Mental  Hygiene. 


14 


APPENDIX  II 


The  officers  of  The  Connecticut  Society  for  Mental  Hygiene, 
as  of  the  date  May  1,  1910,  are: 

President,  Dr.  George  Blumer,  New  Haven ;  Vice  Presidents, 
Hon.  Costello  Lippitt,  President  of  the  Board  of  Trustees  of  the 
Norwich  State  Hospital ;  Hon.  Frank  B.  Weeks,  President  of  the 
Board  of  Trustees  of  the  Connecticut  State  Hospital;  Treasurer, 
W.  Perry  Curtiss,  Vice  President  of  the  New  Haven  Trust  Com¬ 
pany;  Executive  Committee,  Dr.  Henry  S.  Noble,  Superintendent, 
Connecticut  State  Hospital,  Middletown;  Mr.  Lewis  H.  English, 
New  Haven;  Dr.  George  H.  Knight,  Superintendent  of  the  Con¬ 
necticut  School  for  Feeble  Minded,  Lakeville;  Judge  L.  P.  Waldo 
Marvin,  Probate  Court,  Hartford ;  Dr.  Henry  M.  Pollock,  Super¬ 
intendent,  Norwich  State  Hospital ;  Mr.  Charles  G.  Sanford, 
Bridgeport;  Dr.  Whitefield  N.  Thompson,  Superintendent,  Hart¬ 
ford  Retreat,  Hartford ;  Executive  Secretary,  Clifford  W.  Beers, 
39  Church  St.,  New  Haven. 

The  members  of  the  Board  of  Directors  of  The  Connecticut 
Society  for  Mental  Hygiene,  as  of  the  date  May  1 ,  1910,  are : 

Mr.  Max  Adler,  New  Haven;  Professor  William  B.  Bailey, 
Yale  University;  Mrs.  Thomas  G.  Bennett,  New  Haven;  Mr. 
Tames  Kingsley  Blake,  New  Haven ;  Dr.  George  Blumer,  Yale 
Medical  School;  Hon.  Charles  F.  Brooker,  Ansonia;  Dr.  John 
L.  Buel,  Superintendent,  Spring  Hill  Sanitarium.  Litchfield ;  Mr. 
Henry  S.  Chase,  Waterbury ;  Dr.  Benjamin  IT.  Cheney,  New 
Haven;  Major  Louis  R.  Cheney,  Hartford;  Professor  Russell 
H.  Chittenden,  Director,  Sheffield  Scientific  School ;  Mr.  W. 
Perry  Curtiss,  New  Haven ;  Dr.  A.  Ross  Diefendorf,  Lecturer 
on  Psychiatry,  Yale  Medical  School ;  Dr.  Charles  A.  Dinsmore, 
D.D.,  Waterbury;  Mr.  John  I.  H.  Downes,  New  Haven;  ex- 
President  Timothy  Dwight,  Yale  University;  Dr.  Gustavus  Eliot, 
New  Haven ;  Mr.  Lewis  H.  English,  New  Haven ;  Professor 
Irving  Fisher,  Yale  University;  Mr.  J.  Edward  Heaton,  New 
Haven ;  Mr.  Everett  G.  Hill,  New  Haven  ;  Mr.  William  T.  Hincks, 


15 


Bridgeport;  Mr.  William  J.  Hoggson,  Greenwich;  Mr.  Thomas 
Hooker,  New  Haven;  Dr.  George  H.  Knight,  Lakeville;  Hon. 
Costello  Lippitt,  Norwich;  Professor  Thomas  R.  Lounsbury,  Yale 
University;  Judge  L.  P.  Waldo  Marvin,  Hartford;  Hon.  George 
P.  McLean,  Simsbury;  Mr.  James  T.  Moran,  New  Haven;  Dr. 
Henry  S.  Noble,  Middletown;  Dr.  S.  B.  Overlock,  Pomfret;  Dr. 
Henry  M.  Pollock,  Norwich;  Mr.  Alfred  Atmore  Pope,  Farm¬ 
ington;  Dr.  Henry  W.  Ring,  New  Haven;  Mr.  Charles  G.  San¬ 
ford,  Bridgeport;  Mr.  Arthur  H.  Shipman,  Hartford;  Dr.  Fred¬ 
erick  T.  Simpson,  Hartford ;  Rev.  Anson  Phelps  Stokes,  Jr.,  Yale 
University;  Mr.  Horace  D.  Taft,  Watertown;  Dr.  Whitefield  N. 
Thompson,  Hartford;  Col.  Rutherford  Trowbridge,  New  Haven; 
Mr.  Howard  B.  Tuttle,  Naugatuck;  Mr.  Victor  Morris  Tyler. 
New  Haven;  Col.  Isaac  M.  Ullman,  New  Haven;  Mr.  George 
C.  Waldo,  Bridgeport;  Hon.  Thomas  M.  Waller,  New  London; 
Hon.  Frank  B.  Weeks,  Middletown;  Mr.  John  H.  Whittemore, 
Naugatuck. 


